Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial.

Aanesen, F; Grotle, M; Rysstad, TL; Storheim, K; Tveter, AT; Tingulstad, A; Løchting, I; Småstuen, MC; van Tulder, MW; Berg, R; Wynne-Jones, G; Sowden, GH; Fors, E; Bagøien, G; Foster, NE; Hagen, R; Øiestad, BE

Abstract

OBJECTIVES: To evaluate if adding motivational interviewing (MI) or a stratified vocational advice intervention (SVAI) to usual case management (UC), reduced sickness absence over 6 months for workers on sick leave due to musculoskeletal disorders. METHODS: We conducted a three-arm parallel pragmatic randomised controlled trial including 514 employed workers (57% women, median age 49 (range 24-66)), on sick leave for at least 50% of their contracted work hours for =7 weeks. All participants received UC. In addition, those randomised to UC+MI were offered two MI sessions from social insurance caseworkers and those randomised to UC+SVAI were offered vocational advice from physiotherapists (participants with low/medium-risk for long-term sickness absence were offered one to two sessions, and those with high-risk were offered three to four sessions). RESULTS: Median sickness absence was 62 days, (95% CI 52 to 71) in the UC arm (n=171), 56 days (95% CI 43 to 70) in the UC+MI arm (n=169) and 49 days (95% CI 38 to 60) in the UC+SVAI arm (n=169). After adjusting for predefined potential confounding factors, the results showed seven fewer days in the UC+MI arm (95% CI -15 to 2) and the UC+SVAI arm (95% CI -16 to 1), compared with the UC arm. The adjusted differences were not statistically significant. CONCLUSIONS: The MI-NAV trial did not show effect on return to work of adding MI or SVAI to UC. The reduction in sickness absence over 6 months was smaller than anticipated, and uncertain due to wide CIs. TRIAL REGISTRATION NUMBER: NCT03871712.

Citation

Aanesen, F., Grotle, M., Rysstad, T., Storheim, K., Tveter, A., Tingulstad, A., Løchting, I., Småstuen, M., van Tulder, M., Berg, R., Wynne-Jones, G., Sowden, G., Fors, E., Bagøien, G., Foster, N., Hagen, R., & Øiestad, B. (2022). Effectiveness of adding motivational interviewing or a stratified vocational advice intervention to usual case management on return to work for people with musculoskeletal disorders: the MI-NAV randomised controlled trial. Occupational and Environmental Medicine, 42-50. https://doi.org/10.1136/oemed-2022-108637

• Acceptance Date: Oct 26, 2022
• Publication Date: Nov 25, 2022
• Journal: Occupational and Environmental Medicine
• Print ISSN: 1351-0711
• Electronic ISSN: 1470-7926
• Publisher: BMJ Publishing Group
• Pages: 42-50
• DOI: https://doi.org/10.1136/oemed-2022-108637
• Keywords: Occupational Health; Rehabilitation; Sick Leave; Musculoskeletal System
• Public URL: https://keele-repository.worktribe.com/output/425091
• Publisher URL: https://oem.bmj.com/content/80/1/42